Background
[0001] Tilidine, systematic name (±)-
trans-ethyl 2-(N,N-dimethylamino)-1-phenylcyclohex-3-enylcarboxylate, is a synthetic opioid
analgesic, commonly prescribed for acute and chronic pain. As the systematic name
implies, it is a racemic mixture of the
1S,2R and
1R,2S compounds, the two
trans-configured stereoisomers. Upon ingestion, it is rapidly metabolised undergoing demethylation
to the pharmacologically active nortilidine, systematic name (±)-
trans-ethyl 2-(N-methylamino)-1-phenylcyclohex-3-enylcarboxylate; the minor metabolite
(±)-
trans-ethyl 2-amino-1-phenylcyclohex-3-enylcarboxylate, trivial name bisnortilidine is
also formed (Figure 1). Its opioid activity has led to its abuse and there is a need
for its detection for toxicological purposes e.g. in individuals who drive while intoxicated,
and for therapeutic drug monitoring. Various methods of detecting tilidine and its
metabolites, mostly based on expensive, relatively complex laboratory-based mass-spectrometry
and chromatographic techniques, are described e.g.
Kohler et al (Anal.Bioanal.Chem., 2011, 400:17-23) describe a liquid chromatography-mass-spectrometry (LC-MS-MS) system. However, more
sensitive, cheaper and simpler detection methods amenable to application in the field
are desirable.
Figures
[0002]
Figure 1 Structure of tilidine, nortilidine and bisnortilidine
Figure 2 Preparation of hapten N-(carboxypropyl)nortilidine
Description of the Invention
[0003] The invention describes a method of detecting or determining tilidine and nortilidine
in an
in vitro sample of an individual comprising; contacting the sample with one or more detecting
agents and one or more antibodies; detecting, or determining the quantity of the one
or more detecting agents; and deducing from calibrators the presence of or amount
of tilidine and nortilidine in the sample or solution, the one or more antibodies
characterised by having been derived from an immunogen of formula I

wherein n=0 or 1; when n=1 the crosslinker joins the nitrogen atom to the accm, the
antigenicity conferring carrier material. By 'detecting' is meant qualitatively analysing
for the presence or absence of a substance. By 'determining' is meant quantitatively
analysing for the amount of substance present. For convenience, throughout this specification,
tilidine is represented as the
1S,2R trans isomer; whenever the
1S,2R trans isomer is depicted the
1R,2S is also embraced unless otherwise stated. Hence formula I implies a mixture of the
1S,2R and
1R,2S trans isomers; although a racemate, i.e. 1:1 ratio of enantiomers, is the preferred mixture
of the invention, variations which deviate from the 1:1 ratio of each
trans enantiomer are also readily applied to the invention. It would be recognised by the
skilled person that preparative isolation of either of the
trans isomers of tilidine or a derivative of tilidine, or by using asymmetric synthetic
methods, or both, enantiomeric immunogens could be produced for raising antibodies
which would bind to tilidine and its metabolites. As the antibodies of the invention
are able to bind tilidine and nortilidine, quantitative analysis will take the form
of measuring the calibrator-equivalent amount. Any suitable
in vitro biological sample may be used, but blood and urine are preferred.
[0004] The invention further describes an immunogen of formula I in which the crosslinker,
if present, is -X-Y-. Although any suitable crosslinker may be used (see Methods and
Results section), a preferred crosslinker is represented by -X-Y- in which X, which
is attached to the nitrogen atom, is selected from a group comprising a substituted
or or unsubstituted , straight or branched chain, saturated or unsaturated alkylene
moiety; preferably X is C1-C10 alkylene, preferably a C1-C6 alkylene moiety. Y is
a divalent functional group selected from -C(O)-, -NH-, maleimide

-N-C(O)-, - N-C(S)-, -S-, -S(O)
2-, and -S(O)- wherein the bracketed atom is attached to the preceding C-atom or S-atom
by a double bond e.g. -C(O)- refers to carbonyl. In a preferred embodiment the crosslinker
is -CH
2-CH
2-CH
2-C(O)-. The accm, is a standard component of an immunogen derived from a small molecule
and can be any macromolecule that confers immunogenicity to the non-immunogenic small
molecule (see Methods and Results section) but is preferably chosen from keyhole limpet
haemocyanin (KLH), bovine thyroglobulin (BTG), bovine serum albumin (BSA), egg ovalbumin,
bovine gamma globulin or cationised BSA.
The invention further describes an antibody derived from an immunogen of formula I.
The antibody is further characterised in being specific to an epitope of tilidine.
By specific it is meant that the antibody preferably binds or has greater affinity
for tilidine compared to all other molecules. The relative degree of binding of an
antibody to a molecule can be described by its cross-reactivity (CR) which can be
derived from a suitable metric such as the IC
50 (see Table 1), the molecule with the greatest amount of binding being given a CR
value of 100%. Thus the antibody of the current invention has a CR of 100% to tilidine.
The antibody preferably is cross-reactive to nortilidine. The extent of cross-reactivity
of the antibody to nortilidine is preferably >10 % more preferably >20%. Preferably,
the antibody also shows cross-reactivity to bisnortilidine.
[0005] In a further embodiment the invention describes a kit for detecting or determining
tilidine and nortilidine; the kit comprises at least one antibody specific to tilidine
and having cross-reactivity to nortilidine. The kit may also contain a detecting agent
comprising a hapten based on the tilidine structure. The detecting agent comprises
a suitable hapten, preferably the haptens disclosed herein, covalently bonded to a
detectable labelling agent, the hapten moiety being able to bind to the antibodies
of the invention. Preferably, the labelling agent is selected from an enzyme, a luminescent
substance, a radioactive substance, or a mixture thereof. More preferably, the labelling
agent is an enzyme, preferably a peroxidase, most preferably horseradish peroxidise
(HRP). The kit may comprise one or more antibodies of the invention and one or more
additional antibodies with different molecular specificities i.e. these additional
antibodies do not bind to the same structural epitopes as the antibodies of the invention.
Such an arrangement enables a multiplexing approach to the detection or determination
of drugs of abuse. The multiplexing approach preferably makes use of a planar substrate
to which the antibodies are attached, such as a ceramic chip or an appropriately surface-modified
glass slide. Beads may also be used.
Methods and Results
Preparation of Haptens, Immunogens and Detecting Agents
[0006] The general process of immunogen formation is well known. Briefly, a hapten (a pre-immunogenic
structure) whose structure incorporates the structural epitope(s) to be recognized
by the antibody, is synthesized by introducing a crosslinker. The crosslinker provides
the functional groups which will enable an antigenicity conferring carrier material
(accm) to be attached to the hapten. The crosslinker is not always necessary if it
is considered that the accm can be directly attached to an existing molecule which
incorporates the required structural elements for immunogen attachment. The crosslinker
may also be transient in nature, being a structural group which activates the hapten
to accm introduction but which is not present in the final immunogen (e.g. N,N-dicyclohexylcarbodiimide
and N-hydroxysuccinimide). Further examples of crosslinking agents include 1-cyclohexyl-3-(2-morpholino-yl-ethyl)carbodiimide,
1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC), 2-iminothiolane, 3-maleimidobenzoic
acid , glutardialdehyde, succinimidyl 4-(N-maleimidomethyl)cyclohexane-1-carboxylate,
N-succinimidyl-3-(2-pyridyldithio) propionate,. A comprehensive list of crosslinkers
can be found in the
Thermo Scientific Pierce Crosslinking Technical Handbook, 2009. As previously described, although small molecules (haptens) provide defined structural
epitopes, they are not in themselves immunogenic and therefore need to be conjugated
to carrier materials, which will elicit an immunogenic response when administered
to a host animal.
[0007] Appropriate carrier materials commonly contain poly(amino acid) segments and include
polypeptides, proteins and protein fragments. Illustrative examples of useful carrier
materials are BSA, egg ovalbumin, bovine gamma globulin, cationized serum albumin,
BTG, KLH, dextranes etc. Alternatively, synthetic poly(amino acids) having a sufficient
number of available amino groups, such as lysine, may be employed, as may other synthetic
or natural polymeric materials bearing reactive functional groups. Also, carbohydrates,
yeasts or polysaccharides may be conjugated to the hapten to produce an immunogen
(
Bioconjugate Techniques, G. Hermanson, ed, Academic Press, 1996, 785pp, lists common carrier proteins). The haptens can also be coupled to a detectable
labelling agent such as an enzyme (for example, horseradish peroxidase), a substance
having fluorescent properties or a radioactive label for the preparation of detecting
agents for use in the immunoassays. The fluorescent substance may be, for example,
a monovalent residue of fluorescein or a derivative thereof. Immunogen formation for
the invention described herein involves conventional conjugation chemistry. In order
to confirm that adequate conjugation of hapten to carrier material has been achieved,
prior to immunisation, each immunogen is evaluated using matrix-assisted UV laser
desorption /ionisation time-of-flight mass spectroscopy (MALDI-TOF MS). Formation
of the conjugate (detecting agent) from a hapten follows similar principles to immunogen
formation.
General Procedure for MALDI-TOF Analysis of Immunogens.
[0008] MALDI-TOF mass spectrometry was performed using a Voyager STR Biospectrometry Research
Station laser-desorption mass spectrometer coupled with delayed extraction. An aliquot
of each sample to be analysed was diluted in 0.1 % aqueous trifluoroacetic acid (TFA)
to create 1 mg/ml sample solutions. Aliquots (1µl) were analysed using a matrix of
sinapinic acid and bovine serum albumin (Fluka) was used as an external calibrant.
Preparation of Antisera
[0009] In order to generate polyclonal antisera, an immunogen of the present invention is
mixed with Freund's adjuvant and the mixture is injected into a host animal, such
as rabbit, sheep, mouse, guinea pig or horse. Sheep are the preferred host animal.
Further injections (boosts) are made and serum is sampled for evaluation of the antibody
titre. When the optimal titre has been attained, the host animal is bled to yield
a suitable volume of specific antiserum. The degree of antibody purification required
depends on the intended application. For many purposes, there is no requirement for
purification, however, in other cases, such as where the antibody is to be immobilised
on a solid support, purification steps can be taken to remove undesired material and
eliminate non-specific binding.
Immunoassay Development
[0010] The process of developing an immunoassay is well known to the person skilled in the
art. Briefly, for a competitive immunoassay in which the target analyte is a non-immunogenic
molecule such as a hapten, the following process is conducted: antibodies are produced
by immunising an animal, preferably a mammalian animal, by repeated administration
of an immunogen. The serum from the immunised animal is collected when the antibody
titre is sufficiently high. A detecting agent is added to a sample containing the
target analyte and the raised antibodies, and the detecting agent and analyte compete
for binding to the antibodies. The process may comprise fixing said serum antibodies
to a backing substrate such as a microtitre plate, a polystyrene solid support or
a ceramic chip. The antibodies can be polyclonal or monoclonal. The signal emitted
in the immunoassay is proportionate to the amount of detecting agent bound to the
antibodies which in turn is inversely proportionate to the analyte concentration.
The signal can be detected or quantified by comparison with a calibrator.
[0011] In the following Examples, the numbers following chemical names refer to the structure
of Figure 2
Example 1: Preparation of bisnortilidine 2.
[0012] Zinc activation: Zn (5g) was washed successively with HCl (2%), water, ethanol and
finally with ether before being dried under high vacuum. To a solution of N-(2,2,2-trichloroethoxy)carbonyl
bisnortilidine 1 (900mg, 2.14mmol; Toronto Research Chemicals Inc.) in acetic acid
(10.8ml) at room temperature was added Zinc dust activated (1.43g, 0.021 mol) portion-wise
and the resulting mixture was stirred at room temperature overnight. The reaction
mixture was filtered and washed by acetic acid. The combined acetic acid was removed
in vacuo and the resulting residue was taken into NaOH (2N) solution and extracted
several times with chloroform. The organic layer were dried over sodium sulfate, filtered
and concentrated to dryness to give 593.5mg of bisnortilidine
2 as clear oil.
Example 2: Preparation of N-(carboxypropyl)bisnortilidine 3
[0013] To a cooled solution 0°C of bisnortilidine 2 (469mg, 1.91mmol) in anhydrous tetrahydrofuran
(3ml) was added aqueous succinic semialdehyde (1.69ml, 2.48mmol) followed by the addition
of sodium cyanoborohydride (120mg, 1.19mmol). The reaction mixture was stirred for
2 hours. To this solution was added a solution of HCl (1 N) (3ml) and the reaction
mixture stirred at room temperature for 2 hours. The reaction mixture was concentrated
in vacuo and the residue made neutral with a solution of NaOH (1 N) and extracted
with chloroform. The aqueous phase was concentrated in vacuo and extracted with (10%)
methanol in chloroform. The organic fractions were combined and evaporated to give
331.7mg of N-(carboxypropyl)bisnortilidine
3.
Example 3: Preparation of N-(carboxypropyl)nortilidine (Hapten)
[0014] To solution of N-(carboxypropyl)bisnortilidine 3 (331.7mg, 1 mmol) in acetonitrile
(ACN) (2ml) was added potassium carbonate (317mg, 2.3mmol) and methyl iodide (93.4µl,
1.5mmol) and the reaction mixture was stirred at room temperature overnight. The solution
was concentrated in vacuo and the residue was taken in water. The mixture was neutralized
the pH7 with HCl (1 N) and extracted with ethyl acetate. The combined organic layers
were dried over sodium sulfate, filtered and concentrated to dryness. The residue
was purified by column chromatography (silica gel, 10% methanol in chloroform) to
give 146mg of N-(carboxypropyl)nortilidine (Hapten) as oil.
Example 4: Conjugation of N-(carboxypropyl)nortilidine (Hapten) to BSA (Immunogen-I)
[0015] To a solution of N-(carboxypropyl)nortilidine (Hapten) (38.7mg, 0.112mmol) in DMF
(1.0ml) was added N,N-dicyclohexylcarbodiimide (DCC) (25.35mg, 0.123mmol) and N-hydroxysuccinimide
(14.13mg, 0.123mmol) and the mixture stirred at room temperature overnight. The dicyclohexylurea
formed was removed by filtration and the solution was added dropwise to a solution
of BSA (150mg, 2.3mmol) in 50mM sodium bicarbonate solution (pH 8.5) (10ml). The mixture
was then stirred overnight at 4°C. The solution was then dialysed against 50mM phosphate
buffer pH 7.2 (3 changes) for 24 hours at 4°C, and freeze-dried. MALDI results showed
24.99 molecule of N-(carboxypropyl)nortilidine (Hapten) had been conjugated to one
molecule of BSA.
Example 5: Conjugation of N-(carboxypropyl)nortilidine (Hapten) to BTG (Immunogen-II)
[0016] To a solution of N-(carboxypropyl)nortilidine (Hapten) (46.63mg, 0.135mmol) in DMF
(1.0ml) was added N,N-dicyclohexylcarbodiimide (DCC) (30.7mg, 0.149mmol) and N-hydroxysuccinimide
(17.13mg, 0.149mmol) and the mixture stirred at room temperature overnight. The dicyclohexylurea
formed was removed by filtration and the solution was added dropwise to a solution
of BTG (150mg, 2.25umol) in 50mM sodium bicarbonate solution (pH 8.5) (10ml). The
mixture was then stirred overnight at 4°C. The solution was then dialysed against
50mM phosphate buffer pH 7.2 (3 changes) for 24 hours at 4°C, and freeze-dried.
Example 6: Conjugation of N-(carboxypropyl)tilidine (Hapten) to HRP
[0017] EDC hydrochloride (10mg) was dissolved in water (0.5ml) and immediately added to
a solution of N-(carboxypropyl)tilidine (Hapten) (2mg) in DMF (0.2ml). After mixing,
this solution was added dropwise to a solution of HRP (20mg) in water (1ml). Sulfo-NHS
(5mg) was added and the reaction mixture was incubated in the dark at room temperature
overnight. Excess hapten was removed with double PD-10 columns (Pharmacia) in series,
pre-equilibrated with PBS at pH 7.2. The hapten-HRP conjugate was then dialysed overnight
against 10L of PBS at pH 7.2 at 4°C.
Example 7: Immunoassay development
[0018] The wells of an enhanced binding 96 well polystyrene microtitre plate were coated
with the Ig fraction of the antiserum raised to Immunogen II (tilidine-BTG), diluted
in 10mMTris, pH 8.5 (125µl/well). The appropriate antibody coating dilution was determined
using standard ELISA checkerboard techniques. The plate was incubated for 2 hours
at 37°C, washed 4 times over 10 minutes with Tris buffered saline, containing Tween
20 (TBST) and tapped dry. Standard solutions of tilidine hydrochloride and nortilidine
hydrochloride were prepared in TBST at 0, 0.625ng/ml, 1.25ng/ml, 2.5ng/ml, 5ng/ml,
10ng/ml, 20ng/ml and 40ng/ml and 50µl of each was added to the appropriate wells (Figure
1). 75µl of conjugate of example 6 (hapten-HRP), diluted in Tris buffer (pH7.2) containing
EDTA, D-mannitol, sucrose, thimerosal and BSA was added to each of the wells. The
appropriate dilution of conjugate was also determined using standard ELISA checkerboard
techniques. The plate was incubated at 25°C for 1 hour. Excess unbound conjugate was
removed by washing 6 times over a 10-15 minute period with TBST. 125µl of tetramethylbenzidine
(TMB) substrate solution was added to each well of the plate that was then incubated
for 20 minutes in the dark at room temperature. The reaction was terminated by the
addition of 125µl of 0.2M H
2SO
4 to each well. The absorbance was then measured at 450nm using a microtitre plate
reader.
Table 1 Binding characteristics of tilidine-specific antibody raised from Immunogen -II using
conjugate of Example 6 as detecting agent
| |
Tilidine |
Nortilidine |
| Standard ng/ml |
A450 |
% B/Bo |
A450 |
% B/Bo |
| 0 |
1.561 |
100 |
1.551 |
100 |
| 0.625 |
0.989 |
63 |
1.227 |
79 |
| 1.250 |
0.861 |
55 |
1.129 |
73 |
| 2.500 |
0.714 |
46 |
1.004 |
65 |
| 5.000 |
0.572 |
37 |
0.904 |
58 |
| 10.000 |
0.444 |
28 |
0.745 |
48 |
| 20.000 |
0.319 |
20 |
0.571 |
37 |
| 40.000 |
0.212 |
14 |
0.426 |
27 |
| IC50 ng/ml |
1.820 |
8.522 |
| % cross-reactivity |
100 |
21.36 |
A450 = absorbance at 450nm; B= absorbance at 450nm at x ng/ml standard concentration;
Bo= absorbance at 450nm at 0 ng/ml standard concentration;
IC50= standard concentration which produces 50% B/B |
[0019] Repetition of Example 7, in which the nortilidine standard was replaced by bisnortilidine
hydrochloride, showed bisnortilidine to have a cross-reactivity of 15.40 % compared
to tilidine (100 %).